1. Field of the Invention
This invention relates to a self-contained powered surgical apparatus for applying surgical fasteners to body tissue.
2. Description of the Related Art
Hernias may be divided into three general classes: direct hernia, indirect hernia and femoral hernia. In a direct or indirect inguinal hernia, often a part of the intestine protrudes through a defect in the supporting abdominal wall to form a hernial sac requiring surgery which generally includes a surgical incision in the groin ranging up to six inches in length. Several layers of the abdominal wall are generally separated to reach the herniated portions. During the procedure, the hernia is closed outside the abdominal wall in a manner which resembles the tying of a sack at the neck. Often a surgical mesh is attached by sutures directly over the hernia repaired opening to provide a reinforcement to the opening.
Traditionally, such hernia repairs involved major invasive surgical procedures which often caused excessive trauma to the patient and necessitated unusually long post-operative recuperative periods. In addition, numerous complications, related directly or indirectly to the surgery, often resulted, including bleeding, infection, testicular atrophy, organ damage, nerve damage, blood vessel damage, etc. Furthermore, cutting through the numerous layers of tissue to obtain access to the herniated area often caused severe trauma to the patient.
Invasive surgical procedures have also been utilized in other areas of the body, including surgery on the gall bladder, appendix, lungs and the like. For the reasons previously stated, the use of laparoscopic and endoscopic surgical procedures have been relatively popular and such popularity has provided additional incentive to develop the procedures further.
In laparoscopic procedures, surgery is performed in the interior of the abdomen through a small incision, whereas in endoscopic procedures, surgery is performed in any hollow viscus of the body through narrow endoscopic tubes inserted through small entrance wounds in the skin. Laparoscopic and endoscopic procedures often require the surgeon to act on organs, tissues, and vessels far from the incision, thereby requiring that any instrument used in such procedures be long and slender while being functionally controllable remote from the surgical site. Laparoscopic and endoscopic procedures generally require that any instrumentation inserted into the body be sealed, i.e., provisions must be made to ensure that gases do not enter or exit the body through the laparoscopic or endoscopic incision as, for example, in surgical procedures in which the surgical region is insufflated.
As noted briefly hereinabove, in hernia surgery, a suitable mesh material is generally sutured over the opening in the tissue. The mesh material is often attached by sutures and left within the opening to act as a reinforcing agent for tissue regrowth. Examples of mesh materials currently utilized in hernia surgery include a polypropylene material marketed by United States Surgical Corporation under the trademark SURGIPRO, and a trifluoroethylene material marketed by W. L. Gore & Associates, Newark, Del., under the trademark GORE-TEX.
With the advent of laparoscopic surgery, the need for suitable mesh attachment techniques performable through a relatively narrow endoscopic tube or cannula has been clearly defined. One example of an instrument which is used in laparoscopic hernia procedures is disclosed in U.S. Pat. No. 5,289,963.
Surgeons have also recognized the benefit of surgical instruments that are actuable with only a limited degree of physical force. Self-powered surgical instruments have been provided to serve these needs and include both gas powered surgical instruments as described, for example, in U.S. Pat. Nos. 3,815,476 and 3,837,555, and electrically powered surgical instruments as described, for example, in U.S. Pat. Nos. 4,635,638 and 5,258,007, and European Patent Application No. 0 552 050. In general, prior an electrically powered surgical instruments have been driven by external power sources. The instruments were connected to the power sources by conductive cables. Such cables could, however, become entangled during a surgical procedure, thereby complicating the operation.
It would be beneficial to provide a self-contained powered surgical apparatus for applying staples to body tissue to approximate tissue and to attach surgical mesh to body tissue. Such an apparatus should be compact, lightweight and easy to manufacture. Currently, surgical instruments are designed for use in either open, i.e. invasive procedures or endoscopic/laparoscopic procedures. As noted above, endoscopic instruments require elongated shafts to access remote surgical sites. Conventional surgical instruments are not constructed in this manner. It would be advantageous to provide a powered surgical instrument which can be readily adapted for use in laparoscopic or endoscopic procedures as well as conventional surgical procedures.